WTC Visual Inspection Form, 15 Broad Street

NYC 9/11 Public Portal Document

} WTC Visual Survey Form Premise Address• L l 1~ Block: ResidentialU Commercial U Name of Building: Lot: I Mix Use ❑ Other ❑ # of Stories: 5 AKA's: Building Owner/Management: Telephone Number: (Ztz) Name: c FAX: ( ) Address: On Site Contact: Name: Telephone Number: (l.- t) 2.. Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A es ❑ No No Visible/Fine Layer ❑'/ to 1" ❑ > 1" South ❑ N/A es ❑ No No Visible/Fine Layer ❑ to 1" 1/ 2 ❑ > 1" East ❑ N/A BYes ❑ No No Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1" West ❑ N/A fes ❑ No to Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer '/2 to 1" ❑ > 1" Description: 1 Eli --TILE 5 ' ENTI I2e 2 (2-C"—Qu c, c a_,—

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"

Comments

Date: 'L- / t -' /2002 Inspection by: Name: , Name: Agency:

NYC-WTC-000118700